Apparatus for administering controlled volumes of gas



Nov. 8, 1966 H. GOODNER APPARATUS FOR ADMINISTERING CONTROLLED VOLUMES0F GAS Filed July 12 1965 4 Sheets-Sheet 1 INVENTOR. MON/POZHARRYGOODA/EAZDl-ZZASKL HTTORNIFK Nov. 8, 1966 M. H. GOODNER APPARATUS FORADMINISTERING CONTROLLED VOLUMES OF GAS 4 Sheets-Sheet 2 Filed July 12.1963 Nov. 8, 1966 M. H. GOODNER 3,283,754

APPARATUS FOR ADMINISTERING CONTROLLED VOLUMES 0F GAS Filed July 12 19634 Sheets-Sheet 5 HTTORNE').

Nov. 8, 1966 M. H. GOODNER 3,283,754

APPARATUS FOR ADMINISTERING CONTROLLED VOLUMES OF GAS Filed July 12 19634 SheetvSheet 4= l 72 14, I I l 7 76' 54 :JZ I T F W/M 75 HTTORNEYUnited States Patent 3,283,754 APPARATUS FOR ADMINISTERING CON- TROLLEDVOLUMES 0F GAS Monroe Harry Goodner, deceased, late of Little Silver,

N.J., by Helen L. Goodner, executrix, Little Silver, N.J.,

assignor to Stephenson Corporation, Red Bank, N.J., a

corporation of New Jersey Filed July 12, 1963, Ser. No. 294,767 8Claims. (Cl. 128-29) This invention relates to apparatus for supplying acontrolled volume of gas to a patents lungs. It can be used forsupplying gases comprising anesthesia gas, as for example during anoperation, or for supplying oxygen alone or mixed with air, as forexample for resuscitation. It can be quickly shifted from one of theseuses to the other or for manually controlled resuscitation.

The term gas is used herein broadly and includes ambient air, oxygen,anesthesia gases and any gas or gases used in connection with anesthesiaor reviving a patient or promoting his breathing.

It is an object of the invention to provide improved apparatus of theabove mentioned kind.

Another object of the invention is to supply a predetermined volume ofgas for each inhalation phase of the breathing cycle.

Another object of the invention is toprovide apparatus which will notonly deliver a constant volume of gas to the patients lungs during eachinhalation phase for each volume setting of the device, but will alsodeliver the successive equal volumes of gas during substantially thesame periods of time, thus maintaining an even breathing rhythm.

Another object of the invention is to provide power means forintermittently collapsing a gas container to supply gas to a patientslungs, in combination with self regulating control means responsive tovariations in the force required to deliver gas through a patientsbreathing passages to his lungs.

The invention will best be understood if the following description isread in connection with the drawings in which:

FIGURE 1 is perspective view looking at the front and one end of anembodiment of the invention,

FIGURE 2 is a diagrammatic and schematic view of the device illustratedin FIGURE 1, showing particularly the conduit and control means of boththe therapeutic and power systems comprising the embodiment,

FIGURE 3 is a top view, and FIGURE 4 is a side view partly in crosssection of valve means for controlling the supply of power gas inproportion to the power required under changing conditions of thepatients breathing passages, for delivering a predetermined volume ofgas to a patients lungs within a predetermined period of time,

FIGURE 5 is a top view, and FIGURE 6 is a side elevation largely incross section of cycling valve means for controlling the flow of powergas to and from the power cylinder,

FIGURES 7 and 7a are top views, partly cut away and in section, andFIGURE 8 is a front elevation, partly cut away and in cross section, ofvalve means in the patients exhalation conduit and of means for settingthe device selectively for open or closed circuit operation,

FIGURE 9 is an elevational view showing a bellows, power cylinder meansby which it is intermittently collapsed, and a valve assembly throughwhich gases for the patients lungs are intermittently supplied to thebellows and exhausted from the bellows to the patient, showing the inletvalve open,

FIGURE 10 is a horizontal section taken on the line 10-10 of FIGURE 9,

FIGURE 11 is a top view of FIGURE 9, showing also means for controllingand adjusting the volume of gas supplied to a patient during eachinhalation phase and for actuating the power cylinder cycling valve,

FIGURE 11a is a detail elevation view looking toward one side of beam132 and showing how it is related at one end to rod 164,

FIGURE 12 is a side elevation partly in section of the structure shownin FIGURE 11,

FIGURE 13 is a detail view of the bellows valve assembly, similar to theview shown in FIGURE 9 but with the inlet valve closed and the outletvalve open for exhausting gas from the bellows,

FIGURE 14 is a vertical sectional view of means controlled by thecircuit selector (open or closed) means for turning on or off the supplyof anesthesia gases,

FIGURE 15 is a top view; FIGURE 16 is a vertical sectional view taken online 1616 of FIGURE 15; and FIGURE 17 is a view taken on the line 17-17of FIGURE 16, of valve means responsive to the valve means shown inFIGURE 14, for simultaneous turning on or oif the supply of a pluralityof anesthesia gases.

The apparatus disclosed herein comprises a first conduit systeminterconnecting between one or more sources of gas and a bellows, andbetween the bellows and a patients face mask, and a second conduitsystem interconnecting between a power cylinder and piston, by which thebellows is intermittently collapsed, and a source of gas under pressurefor actuating the piston, and also between a source of gas underpressure and a triple valve actuating valve. For convenience the gas orgases to be supplied to the patient may be referred to as patients gasand the gas for actuating the piston and the triple valve may bereferred to as power gas. One of the patients gases is oxygen underpressure supplied from a pressure container, and gas from the samecontainer, indicated as 24 in FIGURE 1, may conveniently be alsoemployed as power gas, to operate the power cylinder and the triple:valve, as will be described.

The apparatus includes yokes for supporting tanks of gases, such asoxygen, cyclopropane and nitrous oxide, and having ports for connectingthem to the conduit system leading to the patient. The yoke means forthe oxygen supply also has a plurality of ports for oxygen to be used aspower gas, for operating the power cylinder and the triple valve.

As shown herein conduits 12 and 14 lead from a plurality of sources 16and 18 of anesthetic gas under pressure (FIGURE 4) to a triple valve 20,and conduit 22, leading from a source 24 of oxygen under pressure, has abran-ch 22a which leads to said triple valve 20. From this triple valve20 tubes 26 and 28 lead to a conduit 38 which leads to the bellows inletchamber 40, and tube 30 leads from triple valve 20 to a vaporizer 32 forother which in turn is connected to conduit 38 by conduit 34. Conduit 22leads from the oxygen source 24 to a tube 36 which, like tubes 26 and 28leads to the conduit 38.

\ Tubes 26, 28, 30, and 36 are tapered from bottom to top and havetherein floats (not shown) of known kind which indicate by theirpositions in the tubes the amount of gas fiow within said tubesrespectively. In addition to the triple valve means 20 the tubes 26, 28,3t) and 36 have the individual valve means 27, 29, 31 and 37 forcontrolling the amount of gas supplied through the tubes respectively.

Communicating with conduit 38 in advance of bellows 42, through branchconduit 44, is a flexible storage bag 46 which serves both as a gasmixing chamber and a reserve supply of mixed gases. Bag 46 may bemanipulated by hand if for any reason manual control of the supply ofgases to the patient is desired. In that event the bellows is locked incollapsed position by latch means, such for example as is shown inFIGURE 12, and is by- 3 passed the patients gases flowing from bag 46directly to the patients face mask, and the flow of power gas to thepower cylinder is cut off automatically, as will be described.

Also communicating with conduit 38, through branch conduit 48, is anadjustable air intake valve 51 through which air may be supplied to thepatient, usually mixed with oxygen, or with oxygen and the anesthesiagases as desired. In FIGURE 1 a dial 24a is shown which indicates thepressure of oxygen in a tank which has been placed in operative positionin the machine.

Gas which is supplied into the bellows through conduit 38 when thebellows expands, which it does by force of gravity, is expelled from thebellows 42 when it is collapsed, into the patients lungs through thebellows outlet chamber 52 and conduit 54, which leads to the patientsface mask 55. Although a volume of gas, which is constant for eachinhalation phase of the breathing cycle while the volume setting remainsunchanged, is forced into the patients lungs, it is expelled from thelungs by the natural reflex action of the patient. When this occurs gasflows from the patients lungs through the face mask, and through conduit56 into the valve housing 58 which is also connected by conduit 60 withthe interior of bellows 42. The pressure in the bellows 42 while it isbeing collapsed by power means, as will be described, closes the valvemeans 59 within valve housing 58 and prevents the patient from startingto exhale until the predetermined volume of gas for which the volumecontrol means, to be described, is set, has been supplied into thepatients lungs. When the bellows 42 is collapsed i.e.: at the end of theinhalation phase, the exhaled gases depress spring 59a and open valve 59in housing 58 and the exhaled gas passes through valve 59 into thecircuit selector valve 64 from which it is either partly or entirelyexhausted to atmosphere through conduit 61 and exhaust valve 62, or,depending upon the setting of the circuit selector valve 64, it isentirely or partly recycled, passing through conduit 66 to the filter68, which may desirably be a soda lime canister of known kind, and fromit through the one way valve 70 back into conduit 38, between the branchconduit 44 and the bellows 42.

Circuit selector valve 64 comprises the ports 61a and 66a, the ringshaped valve member 65 which is rotatable by the handle 65a and has theopenings x and y adapted in one position to fully register with theports 61a and 66a, and the member 65b which is engaged by handle 65a androtates on the outer surface of the valve body in unison with the member65. The position of member 65 determines whether all or part of theexhaled gas will be recycled. When it is positioned for a fully opencircuit, which is the position when operating the device forresuscitation, the chain 72, which connects the rotatable member 65b ofthe selector valve 64 to the valve stem 76 of the triple valve actuatingvalve means 78 (see FIGURES 7, 9 and 14) raises the valve stem 76 fromport 77 of conduit 80 permitting gas under pressure to flow through 82to the triple valve, and causes the triple valve to close and cut offsimultaneously the flow of anesthesia gases and oxygen from a number ofgas sources, as will be explained; similarly when ring 65 is positionedfor a closed circuit, valve stem 76 is returned to its seat spring 74and cuts off the flow of gas through 82 to the triple valve allowing thetriple valve 20 to open and provide passage for the gases.

Thus it will be seen that the device can be employed to supplyanesthesia gases to a patient, or the anesthesia gases may be shut oifand the device operated as a resusrci'tator, in which case oxygen aloneor mixed with air is supplied to the patient in an open system. Ineither use power gas is employed for collapsing the bellows to forceinto the patients lungs a volume of gas which will be constant for eachinhalation phase while the tidal volume control remains unchanged.

The bellows 42 is secured at the top to the valve plate 4 84 from whichit depends. Valve plate 84 has the ports 41 and 53 through which gasesare supplied into and exhausted from, the interior of the bellowsthrough the chambers and valve means provided in the housing 160 whichis on top of plate 84. A third port 86 through plate 84 leads to thesafety valve 88, which only opens to relieve pressure when the patientsbreathing passages are completely closed. The lower end of the bellowsis secured to the annular base plate member 90 which is mounted on andconnected to the annular cross or a web member 91 having the upwardlyextending sleeve portions 91a which are mounted for reciprocation on theguide rods 92, which extend upwardly from the top of the hood or housing94, within which the conduit systems are housed, to the top plate 84which is stationary.

A cylindrical recess 96 is provided extending through the bottom plate90 and into the lower portion of bellows 42. It is closed at the top bythe wall 98 against which the upper end of piston 11MB presses when itis forced upward in its cylinder 102 by power gas which enters into andis also exhausted from, cylinder 1112 through the port 104, at the lowerend of cylinder 102. The pressure of piston 101 pressing upwardly on thewall 98 of the bellows collapses the bellows, the lower end of whichmoves upwardly and expels any gas within the bellows out through port 53(FIG. 13) into chamber 52, and from chamber 52 into conduit 54 leadingto the patients face mask 55.

The power gas which is supplied into the power cylinder 1 12 flows froma source of gas under pressure, which is source 24 (oxygen) as shownherein, through the conduit 106 into the compensating valve 108, seeFIGURE 4, through the port 110 and out of member 108 through the port112, and through conduit 114 (FIGURE 2) and through valve 115 to theport 116 of the power cylinder cycling valve 118 (FIGURE 6) and fromport 120 of the power cylinder cycling valve through conduit 122 to port104 of the power cylinder 102, and raises piston 100 causing the bellows42 to collapse.

When the bellows is substantially collapsed a projection 90a from itsbottom plate 90 strikes the collar 170 on rod 164 and lifts the rod andtriggers mechanism including pivoted beam 132 which moves valve stemassembly 133 to close port 116 of the cycling valve 118 and therebyinitiates the beginning of the exhalation phase by allowing the powergas to escape from power cylinder 102 and piston 100 to return to itslowered position, causing bellows 42 to expand by gravity. The gasescaping from power cylinder 102 flows back through conduit 122 into thecycling valve 113 through port 120, and is in part quickly exhausted toatmosphere through the port 124 after lifting ball 125 and its stern125a against the force of spring 125b, the remainder of the returninggas being exhausted more slowly through port 126 and conduit 128. Thelatter has in it the valve 130 by which the duration of the patientsexhalation phase may be controlled. Access to ports 124 and 126 isprovided by the lowering of stem 133 and the valve members 1330 and 133dwhich move down with it, as will be more fully explained.

When the bellows is substantially fully expanded the projection 90astrikes the stop or contact member 156 on the lower end of chain 154(FIGURE 12) and thereby again triggers means to be described whichswings the pivoted control beam 132 causing it to elevate valve stem133, thus opening port 116 of the cycling valve 118 and causing gas fromsource 24 to again flow to the power cylinder through valve means 108and 118. The elevation of valve stem 133 and associated parts closesaccess within the valve housing to port 124 and port 126, and gas againflows into 118 through port 116 and out of 118 through port 120 to thepower cylinder 102 to again collapse the bellows and thereby supply gasinto the patients lungs.

If, while the bellows is collapsing, the patients breathing passagesbecome partly closed for any reason it will require more force to expelthe gas from the bellows into the patients lungs. This increasedresistance will be communicated to the gas in power cylinder through thepiston 100 and this back pressure is employed to increase the flow ofpower gas from its source 24 in proportion to the back pressure and thusmaintain substantially constant the speed with which the bellowscollapses, which is an important result since it maintains the breathingrhythm of the patient. The back pressure is communicated to cyclingvalve 118 (FIGURE 6) through conduit 122 and port 120, and from thecycling valve through its port 121 and conduit 123 to the port 113 ofthe compensating valve 168.

Valve 108 (FIGURE 4) comprises the metal plates 134 and 136 which clampbetween them a flexible sheet material forming the two separatediaphragms 138 and 140 on the central portion of each of which a washerassembly w is provided to stiffen the center portions of the diaphragmsrespectively and increase the power they transmit when pressure isexerted against them. Pedestals 142 and 144 are integral with, andproject upwardly from, the washer assemblies w of diaphragms 138 and 140to the opposite ends of a leaf spring 143, the mid-portion of which ispressed downwardly by a pivot screw 145 which is supported by the saddle146.

In port 118 of member 108 a fitting 148 is provided which defines avalve seat 159, and a valve stem 151 projects from diaphragm 138 throughthe fitting 148 and has a conical head portion 152 whichis normallylifted somewhat from its seat to allow gas under pressure from source 24to flow past it into the space below diaphragm 138 and out through port112 through conduit 114 to the cycling valve as has been explained. Whenback pressure from the power cylinder is communicated to port 113 ofcompensating valve 108, through port 121 from the cycling valve, itpresses diaphragm 141) upwardly, elevating pedestal 144 against one endof leaf spring 143 which reacts by pressing downwardly from its otherend on pedestal 142 and a diaphragm 138, thus further lowering the head152 of valve stem 151 from valve seat 158 and allowing an increasedamount of gas to flow from the power gas source 24 into the space belowdiaphragm 138 and out through port 112 and through conduit 114 to thepower cylinder 102 through ports 116 and 120 of the cycling valve. Theincreased flow of power gas equalizes the increased resistance of thepatients breathing passages to the flow of gas from the bellows andenables the bellows to expel its gas and to be successively collapsed atsubstantially the same speed thus producing an inhalation period whichis constant.

The means for controlling the volume of gas to be supplied to a patientis shown in FIGURES 11 and 12 which also show the cycling valveactuating means 132. The chain 154, which is wound around drum 155,passes through an opening in the extension 98a of the plate 90 at thelower end of the bellows and has at its lower end a collar or stopmember 156. When the extension 90a strikes the member 156 it pulls downon chain 154 and the pressure exerted on the chain guide 174 lowers rod164 causing it to swing beam 132 on its pivot and raise stem 133 in thecycling valve 118, thus changing the phase of the power cylinder valveand ending the untolding movement of the bellows. Since it is duringthis movement that the bellows becomes filled with gas, the extent ofsuch movement determines the volume of gas which will be forced into thepatients lungs when the bellows is collapsed. By adjusting the length ofchain 131 as by turning 176 to rotate drum 155, the total volume of gaswhich the apparatus will supply into the patients lungs is changed.

The beam 132 is pivoted at 158 on the valve housing 160 for the bellowsinlet and outlet valves. One end of beam 132 extends into the peripheralsloth 133k in the collar 133a on the valve stem 133 within the cyclingvalve 118, and its other end is loosely fitted in a recess defined bymember 162 which is disposed at the upper 6 end of the verticallymovable rod 164 on the enlarged head portion 165 of the rod. The plate84 at the top of bellows 42 has the extension 84a, and the plate at thelower end of the bellows has the extension 98a, mentioned above.Apertures 166 and 168 are provided in vertical alignment in theextensions 84a and 90:: respectively of the bellows end plates and rod164 extends through these apertures. On the rod 164, between plateextensions 84a and 90a, a collar or stop 176 is provided. The guide 174for chain 154 is supported on the side of the rod head and the roller178 is supported on the guide 174, on the far side of guide 174 from therod head 165.

From the bellows valve housing 160 project four rods r which serve tosupport a plate 172 through which extends the hub 173 of drum 155 onwhich one end of chain 154 is secured. On the hub 173, in front of plate172, a combination finger piece and pointer 176 is provided, and theface of the late is calibrated in terms of volume of gas expelled fromthe bellows each time it is collapsed. By turning member 176 drum 155 isrotated to wind chain 154 on, or unwind it from, the drum, thusincreasing or decreasing the length of chain 154 which results inincreasing or decreasing the volume of gas which will be drawn into thebellows when it expands, and expelled from the bellows when it iscollapsed.

Roller 178 coacts with a pawl 180 pivoted adjacent its lower end onpivot 182 which is supported by bracket means 18 projecting upwardlyfrom plate extension 85. The head of the pawl is urged to swing inwardlytoward roller 178 by spring 186. When the bellows reaches the top of itsstroke the plate extension 90a strikes the stop on rod 164 and pushesthe rod 164 upward until roller 178 has contacted pawl and passed overits point, after causing the head of the pawl to swing inwardly againstthe force of spring 186. When the roller 178 reaches the upper slope ofthe head of pawl 180 the tension of spring 186, acting to urge the headof the pawl against roller 178, will raise rod 164 further until itswings the beam 132 on its pivot 138 and pushes down the valve stem 133of the power cylinder cycling valve 118 thereby closing off any flow ofpower gas from the source 24 to the power cylinder, and releasing thegas accumulated under pressure in the power cylinder, allowing the gasto exhaust from the power cylinder through the cycling valve toatmosphere through ports 124 and 126 as described above, and thusconditioning the bellows 42 to expand by gravity. When the extension 90aof the bellows bottom plate 90 strikes the stop or collar 156 at thelower end of chain 15 4, rod 164 will be moved downwardly causing beam132 to be swung on its pivot in a direction to raise valve stem 133 ofthe power cylinder cycling valve, allowing power gas from source 24 toagain flow to the power cylinder, through port 110 and 112 of thecompensating valve, and ports 116 and 126 of the cycling valve, andinitiate the next inhalation phase 'for the patient by again collapsingbellows 42.

The triple valve 20 has passages which communicate respectively betweenthree separate sets of inlet and outlet ports, 196 and 198, 2410 and202, and 204 and 206, and comprises means for opening and closing all ofthe passages simultaneously. Valve 20 comprises the three portions 190,192 and 194. A flexible sheet of rubber or similar material 208 isclamped between body members 196 and 192 and passes through the spaces193 provided in member 26 between the inner ends of the inlet ports 196,208 and 264 and the inner ends of outlet ports 198, 262 and 206respectively, thus forming three flexible diaphragms d disposed underthe inner ends of the outlet ports respectively. A second flexible sheetof material 210 is clamped between body members 192 and 194 and extendsthrough, anddivides into two portions, a circular chamber 212 defined bythe body members. The port 214 communicates with the portion of chamber212 which is on the far side of the flexible diaphragm 210a from theoutlet ports 198, 202 and 286 and from the three flexible diaphragms ddefined by member 208.

Between diaphragm 210a and diaphragms d the members 216 are provided. Asshown herein, the lower ends of the members 216 extend through recessesin the body 4 portion 192 and rest upon the top of a rigid disc 218,

which in turn rests on the diaphragm 210a and has a stem 218a whichextends up loosely through a bore b in the body portions 190 and 192 andacts as a guide keeping the diaphragm 210a disposed in a straight linewhen it is moved upward by pressure entering from conduit 82. When thisoccurs, :the diaphragms d under the inner ends of outlet ports 198, 202and 206 move up against the inner ends of these outlet portssimultaneously and effectively seal them until the pressure underdiaphragm 210a is relieved.

The triple valve actuating means 78 is a two way valve that in oneposition allows pressure to actuate means in the triple valve to closethe gas passages within the triple valve 20, and in its other positionprovides passages for exhausting gas from the triple valve 20 thusrelieving the pressure under diaphragm 210a of the triple valve. Theport 77 is normally closed by the valve stem 76, preventing pressurefrom the gas container 24 from being communicated into valve 78 throughconduit 80. However, when the circuit selector valve 64 is positionedfor an entirely open circuit the chain 72 will raise the stem 76 invalve 78 and pull valve member 79 against floating valve member 79awhich in turn will be raised against valve seat 7% thereby preventingthe gas from escaping to atmosphere through the body of the valvehousing and the vents 75. Gas from the pressure line 80 will flow intovalve 78 through port 77 and out through the port 81 which connects tothe conduit 82, and through conduit 82 into the triple valve 20, throughport 214 raising the diaphragm 210a and closing the gas passages withinthe triple valve 20. When setting of the selector valve permits, thestem 76 will be returned by spring 74 to close port 77 and this actionallows the power gas to be exhausted from the triple valve by flowingback through conduit 82 into the body of valve 78 and out of valve 78through the vents 75. The reduction of pressure under diaphragm 210awill permit renewed flow of anesthesia gases through valve member 20 totheir respective flow meter tubes and to the conduit 38.

The bellows valve assembly comprises a housing 160 having therein inletand outlet chambers 40 and 52 and a space 43 which is above, andcommunicates between inlet chamber 40 and chamber 45 which communicateswith the bellows through port 41. Inlet chamber 40 has the oneway flapvalve 40a, and outlet chamber 52 has the one-way flap valve 52a. A space43 is provided in inlet chamber 40 above valve 40a and it communicateswith chamber 45 through a slot 1 in the wall dividing chamber 40 fromchamber 45. The valve 40a is heavy enough to close and prevent gasesfrom flowing into the inlet valve chamber on the upward stroke of thebellows. However, it is light enough so that it will lift in response tothe reduced pressure within the bellows when the bellows is expanding.Valve 40a has a projecting finger P which extends into the chamber 45over the top of the bellows port 41 and in alignment with the projectionP extending up from the wall 98 inside the bellows.

A light weight disc 52a is also provided at the bottom of the outletvalve chamber 52 and rests on ring seat 51. It is similar to disc 4011,without the extension arm. It opens when pressure is exerted on itsunder face through port 53 during the compression stroke of the bellows,and allows gas expelled from the bellows to flow from chamber 52 toexhaust conduit 54 and the patients face mask 55.

It will be understood that if it is desired to supply gas to the patientmanually the bellows 42 is locked in collapsed position, as by latch 220(FIGURES 1 and 12) and that in this position the projection P whichextends upwardly from the wall 98 defining the upper end of the recess96, prevents the disc valve member 40a from closing, thus conditioningthe bellows valve assembly to by- 8 pass the bellows and to permit thegases from conduit 38 to flow directly through it from inlet port 40through port 41 to outlet port 52. Latch 220 is shown pivoted at 222 onbracket 224 depending from the extension 84a of the bellows top plate,and held in operative or inoperative position by the toggle spring 226.

A flexible sleeve 230 is provided Within the power cylinder 102, aboveport 104, and its upper portion 230a is bent over inwardly and extendsunder, and is secured to the lower end of the piston 100. A sleeve 232of rigid material, preferably Teflon because of its lubricatingqualities, is provided within the lower portion of cylinder 102 on theinside of the lower portion 23Gb of the flexible sleeve. The sleeve 232is positioned so that it separates the lower pontion 2301) of theflexible sleeve 230 from frictional contact with the turned over andtelescoped upper portion 230a of the flexible sleeve as it descends withthe lower end of the piston.

The power cylinder cycling valve 118 has been referred to and partlydescribed above. It comprises the body portions 236 and 238 and the topplate 240 which is spaced from body portion 238 by the spacers 241. Agasket 237 is provided between 236 and 238. the body portion is achamber 242. A passage 244 extends through body portion 236 from saidchamber and has a valve seat 246, preferably of rubber or compositionmaterial, at its inner end, and a tubing union connection at its otherend which defines the port 116. From chamber 242 a passage 248 extendslaterally in body portion 236, at right angles to passage 244, andcommunicates with two branch passages 250 and 252 which are parallel topassage 244 and have at their outer ends tubing union connectionsrespectively defining the ports 120 and 121. Another passage 254parallel to 244 extends through the body and at one end has the tubingunion connection which defines the port 126 and at its other end,defining port 124 a composition valve seat 256 is provided. Chamber 242communicates with passage 254 through a port 257 and a passage 258 onthe opposite side of chamber 242 from passage 244, extends through thebody portion 238, in alignment with port 256 and passage 244. A valvestem 133 extends through an opening in the top plate 240, and throughpassage 258, and its tapered head extends into passage 244. When theapparatus is at rest, the head stern 133 seats against the seat 246,being urged into this position by the attraction exerted by permanentmagnets 260, supported in top plate 240, upon the soft iron disc 262which is screwed onto the upper end of valve stem 133.

Also mounted on valve stem 133, in the space between top plate 240 andbody portion 238 is the collar 133a which has the peripheral slot 13317in which is engaged one end of pivoted beam 132, as has been described.And adjacent its tapered end, within chamber 242, stem 133 has theintegral radially extending flange 133d, which on its upper surfacedefines a valve seat 271 which is below and opposed to a valve seat 239on the surface of body portion 238 which coacts with body portion 236 todefine chamber 242. A floating, annular valve member 1330 extends aroundstern 133 between the opposed valve seats. When stem 133 is seated, thefloating member 133c rests on seat 271 but when stem 133 is raisedmember 1330 is held between seats 271 and 239 thus closing port 257which leads to passage 254. The ball valve 125, referred to above, ismounted on a stem 125a which is reciprocal in sleeve 276 which extendsthrough top plate 240. The spring 125b extends around the stem 125abetween the ball 125 and the sleeve 276 and urges the ball to seatagainst seat 256 at the top of port 124. When port 257 is closed, powergas cannot flow into passage 254 but when port 257 is open power gasbeing exhausted from the power cylinder and entering member 118 throughport 120 can pass into passage 254 and is exhausted from both ends ofsaid passage, first by lifting ball 125 against the f rce Of pring 125b,and then more gradually, through Defined by V 9 port 126, conduit 128and valve 130 as described above.

There has thus been provided apparatus in which the above stated objectsare accomplished in a thoroughly practical way.

What is claimed is:

1. Apparatus for intermittently administering controlled volumes of gaswhich comprises, a bellows, a cylinder, one or more sources of gas underpressure, first conduit means leading from one or more sources of gas tothe bellows, second conduit means leading from the bellows to supply gasto the patient, third conduit means leading from a source of gas underpressure to said cylinder, means movable in said cylinder in response topressure of gas in said cylinder, means for communicating movement ofsaid means within the cylinder to the bellows to intermittently collapsethe bellows and deliver to the second conduit means equal volumes of gaswithin equal periods of time, and means responsive to back pressure inthe cylinder to pass additional gas from said source to the cylinder inproportion to the amount of said back pressure.

2. The apparatus claimed in claim 1 including plural valve means forcontrolling the supply of gas to the bellows simultaneously from aplurality of said sources.

3. The apparatus claimed in claim 1 in which the means responsive toback pressure in the cylinder comprises compensator valve and cyclingvalve means in the conduit means between said source and said cylinder,and said compensator valve includes a first port communicating with saidsource, a second port communicating with the cylinder intermittentlythrough the cycling valve, and a third port through which back pressurefrom the cylinder is communicated, and means operative in response tosaid back pressure for opening said first and second ports in proportionto the back pressure communicated to said third port.

4. The apparatus claimed in claim 1 in which the said third conduitincludes compensator valve means and a cycling valve including meansresponsive to said bellows to stop the flow of gas to the cylinder andpermit the return flow, and exhaust to atmosphere, of gas from thecylinder.

5. The apparatus claimed in claim 2 comprising means for selectivelyexhausting exhaled gases to atmosphere or returning them to the bellowsfor recycling and including a selector valve, and actuating meansresponsive to the position of the selector valve for controlling theoperation of the plural valve.

6. The apparatus claimed in claim 5 in which the actuating means for theplural valve comprises, a closure having first, second and exhaustports, a first conduit connecting the first port to a source of gasunder pressure, a second conduit communicating between the second portand the plural valve, and means movable in said closure in response tomovements of the selector valve to open said first port and permit gasfrom said source to fiow to the plural valve and to close the pluralvalve, and to close the first port and connect the second port to theexhaust port to permit gas to flow from the plural valve and to open theplural valve.

7. The apparatus claimed in claim 5 in which the plural valve comprises,a housing defining first and second chambers, first and second flexiblediaphragms extending through said chambers respectively, a plurality ofports in the housing wall for connecting said first chamber to aplurality of sources of therapeutic gas under pressure, a plurality ofports in the housing for connecting the first chamber to said bellows,the ports of said first chamber being disposed on the far side of thediaphragm therein from the second chamber, means carried by the firstdiaphragm on the opposite side thereof from the ports of said firstchamber, but in alignment respectively with the said ports forconnection to the bellows, extending into the second chamber and intocontact with the near surface of the diaphragm in said second chamber,and a port communicating with said second chamber, on the far side ofthe diaphragm therein from the said means carried by the firstdiaphragm, through which operating gas may be supplied or discharged tomove said second diaphragm and cause it, through the means carried bythe first diaphragm, to move the first diaphragm to close or open thesaid ports in said first chamber which are for connection to saidbellows.

8. The apparatus claimed in claim 4 in which the cycling valve meanscomprises, a housing defining a cham ber having a first port forconnection through the com pensator valve to a source of operating gas,means movable within said chamber to open and close said port, saidmeans being actuated by the collapsing and expanding movements of saidbellows, a second port for connecting said chamber to said cylinder, athird port for communicating between said chamber and the compensatorvalve, to transmit to the compensator valve the back pressure in thecylinder, a fourth valve operative when the first port is closed toprovide a speedy partial exhaust of gases returned to said chamber fromthe power cylinder when the bellows is expanding, and a fifth portconnected to the atmosphere through a control valve to provide asupplementary means for exhausting operating gas returned from thecylinder and control the rate of expansion of the bellows therebycontrolling the length of the exhalation phase of a breathing cycle.

References Cited by the Examiner UNITED STATES PATENTS 3,058,460 10/1962Goodner 128-29 3,068,856 12/1962 Bird et a]. 128-29 FOREIGN PATENTS908,974 10/1962 Great Britain.

RICHARD A. GAUDET, Primary Examiner. C. F. ROSENBAUM, AssistantExaminer.

1. APPARATUS FOR INTERMITTENTLY ADMINISTERING CONTROLLED VOLUMES OF GASWHICH COMPRISING, A BELLOWS, A CYLINDER, ONE OR MORE SOURCES OF GASUNDER PRESSURE, FIRST CONDUIT MEANS LEADING FROM ONE OR MORE SOURCES OFGAS TO THE BELLOWS, SECOND CONDUIT MEANS LEADING FROM THE BELLOWS TOSUPPLY GAS TO THE PATIENT, THIRD CONDUIT MEANS LEADING FROM A SOURCE OFGAS UNDER PRESSURE TO SAID CYLINDER, MEANS MOVABLE IN SAID CYLINDER INRESPONSE TO PRESSURE OF GAS IN SAID CYLINDER, MEANS FOR COMMUNICATINGMOVEMENT OF SAID MEANS WITHIN THE CYLINDER TO THE BELLOWS TOINTERMITTENTLY COLLAPSE THE BELLOWS AND DELIVER TO THE SECOND CONDUITMEANS EQUAL VOLUMES OF GAS WITHIN EQUAL PERIODS OF TIME, AND MEANSRESPONSIVE TO BACK PRESSURE IN THE CYLINDER TO PASS ADDITIONAL GAS FROMSAID SOURCE TO THE CYLINDER IN PROPORTION TO THE AMOUNT OF SAID BACKPRESSURE.